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Women confront infertility, miscarriage, intimacy problems

March 5, 2017

Reva Judas experienced six miscarriages, and her firstborn baby died 12 hours after birth. That was 29 years ago. Judas is now a grandmother and a chaplain with certification as an infancy and pregnancy loss facilitator.

“We are still educating people that miscarriage is a loss. It is not just a procedure. The grieving process is the same as any loss, and it affects the whole family,” she told NJJN in advance of her participation in a March 19 conference, “The Journey to Healing: How to Cope and Raise Awareness and Sensitivity for Infertility, Miscarriage, and Intimacy Issues.” The women-only event, which is open to the public, will be held at Ahawas Achim B’nai Jacob & David in West Orange.

Nechama Price, a yoetzet halacha in West Orange and Livingston who will moderate the panel, said she receives calls on these topics at least once a week. “So many people are suffering in silence,” she said. “People are not aware of how often it’s occurring.” A yoetzet halacha is a female halachic decisor trained through a two-year course in family purity laws.

One of the conference organizers, Cheryl Munk of West Orange, acknowledged that while none of the topics is exactly taboo, they are “not readily talked about because they are so private.” And beyond the issues themselves is the fact that friends and family members often don’t know how to offer comfort. “They say the wrong thing or they say nothing because they don’t know what to say,” said Munk.

Panelists at the conference will include Judas, founder of NechamaComfort, a Teaneck-based nonprofit providing crisis intervention, guidance, and support in cases of infancy and pregnancy loss; Talia Hindin, a clinical psychologist in private practice in Riverdale specializing in infertility who also serves as director of peer support for those dealing with the issue at the organization Yesh Tikva (literally “There Is Hope”); and Rivki Chudnoff, a physical therapist with an expertise in treating pelvic pain and founder of Hamakom Physical Therapy in Bogota.

Coping with infertility and miscarriage can be compounded for women in Orthodox communities where having many children is highly valued. Hindin views the Orthodox community as a microcosm of secular society, but because of the increased focus on the nuclear family and the fact that community members often have children earlier, there can be more pressure to reproduce. “In a community where couples don’t wait five or six years after getting married to have children, young couples in the community can feel isolated or left out” when they, unlike most others in their cohort, fail to have children, she said.

Infertility affects one in eight couples, according to a 2006-10 National Survey of Family Growth. “One of the most predominant emotions women express is loneliness,” said Hindin. And — given the sheer numbers of those who share the condition — it is ironic “that they feel, ‘I’m the only one,’” she said. One of Hindin’s roles at Yesh Tikva is to create an emotional support system for peers.

The other big issue that arises with infertility, she said, is the occurrence of feelings of embarrassment, shame, and inadequacy. “There are crushed dreams,” Hindin said, and feelings of “I’m a healthy functioning person now with a major malfunction. What’s happening?”

For Hindin, an important “do” is to have a conversation so it’s not a big secret that the fact someone doesn’t have children may not be a choice. “The idea is to get the conversation going so it’s not taboo, and so other people will know how to respond.”

She recommends listening and supporting a couple and validating their pain, using statements like, “I can only imagine how painful this is. It must be a real struggle. I’m here for you. I’m thinking of you.”

In her conversation with NJJN, Judas also emphasized active listening and empathy when dealing with miscarriage and stillbirth. In cases of the death of infants, she said, “I have to educate rabbis who ask me, ‘This is what happened; what should I do?’ I tell them, ‘What if someone’s mother died? It’s the same for this loss.’” When she suffered the loss of the first baby she carried to term, she said, “There was no support in the Jewish world or the secular world.”

Over time, a few support groups came along, and Judas was certified as a chaplain dealing with these issues in 2003; she started NechamaComfort in 2008.

From a halachic perspective, dealing with infant death and pregnancy loss is straightforward. The death of a baby under 30 days of age is treated differently from other deaths — mourning is not required. But that doesn’t mean the loss isn’t complicated emotionally, so she points out that while mourning is not required, neither is it prohibited; creating the space to grieve can be healing. She said that through her group, “We try to give people choices.”

Mostly, she said, the community can help by “reacting like you would with any loss. If you make meals, make the meals. If there are other kids, offer to carpool.” And she added, “Even if there’s no formal shiva, families can set a time when friends can come visit.”

As with any loss, active listening is more useful than saying things that often do more harm than good. Don’t say, according to Judas, “‘At least you have other children.’ If someone’s mother died, you wouldn’t say, ‘At least you have a father.’”

According to the Centers for Disease Control, about 1 percent of all pregnancies result in stillbirths — the loss of a fetus 20 or more weeks into a pregnancy. Each year about 24,000 babies are stillborn in the United States. That is about the same as the number of babies who die each year during the first year of life. By comparison, miscarriage — the loss of a fetus less than 20 weeks into a pregnancy — happens in 15-20 percent of pregnancies.

Words of support that validate pain are suggested ways of comforting friends and family members.

Problems with intimacy is another challenging subject rarely discussed. “We seldom have opportunities for education in this area,” said physical therapist Rivki Chudnoff. “Creating a safe space for education and opportunity for discussion and questions about this important component of a healthy married relationship is critical.”

Price, the community yoetzet, hopes that by hearing the conference speakers, “People suffering will find a voice, and others will learn how to be more sensitive.”